The patient has an order for heparin 100 units over one hour.

Heparin from the pharmacy comes as 10,000 units in 500 ml. The nurse should set the pump to deliver how many ml/hr?

Choice A rationale

Continuous bubbling in the water-seal chamber indicates a persistent air leak within the chest tube system. This is an abnormal finding as bubbling should only occur intermittently during expiration or coughing. A continuous air leak prevents the establishment of a negative intrapleural pressure, compromising the lung's ability to re-expand and can indicate a loose connection or a pleural tear.

Choice B rationale

Bloody drainage in the collection chamber is expected following chest surgery, especially in the immediate postoperative period. The amount and rate of drainage are the key assessments. The drainage should decrease over time.

Choice C rationale

Constant bubbling in the suction-control chamber is the expected and desired finding when suction is applied. This continuous bubbling confirms that the prescribed level of suction is being delivered to the pleural space, which is essential for removing air and fluid and promoting lung re-expansion.

Choice D rationale

Fluid-level fluctuations, also known as tidaling, in the water-seal chamber are a normal and expected finding. This movement reflects the changes in intrapleural pressure during respiration. The fluid level rises with inspiration and falls with expiration, indicating that the chest tube is patent and the lung is not fully re-expanded

Choice A rationale

Eczema, or atopic dermatitis, is a chronic inflammatory skin condition characterized by itchy, red, and swollen skin. While it can be patchy, it typically presents with weeping, crusting, and scaling, but not the thick, silvery scales characteristic of the described rash. Eczema often occurs in skin folds and flexural surfaces, distinguishing it from the patient's presentation.

Choice B rationale

Psoriasis is a chronic autoimmune condition causing an accelerated turnover of skin cells. This rapid proliferation leads to the formation of thick, red patches covered with characteristic silvery scales. The typical locations are the elbows, knees, and scalp, which perfectly matches the patient's presentation, making this the most likely diagnosis.

Choice C rationale

Scabies is a contagious infestation of the skin by the human itch mite. It presents as an intensely itchy rash, often with small, raised red bumps and burrows, typically found in skin folds, between fingers, and on the wrists. It does not produce the thick, silvery scales seen in the patient's rash, making this choice incorrect.

Choice D rationale

Seborrheic dermatitis is a common skin condition that mainly affects the scalp, causing flaky scales and red skin, and is commonly known as dandruff. While it can occur in other oily areas of the body, it does not typically present with the thick, silvery scales on the elbows and knees that are highly indicative of psoriasis. *.